Medicare Supplements (Medigap)

Medicare Supplements

Medicare Supplement Plans (Medigap)

Medicare Supplement plans, also known as Medigap, are private insurance policies designed to cover “gaps” in Original Medicare (Parts A and B). These gaps include out-of-pocket costs such as deductibles, copayments, and coinsurance.

There are 10 standardized Medigap plans available in most states, labeled A through N. Each offers a different level of coverage, allowing individuals to choose a plan that fits their healthcare and financial needs. Medigap policies do not cover prescription drugs (Part D), dental, vision, or long-term care.

To enroll, individuals must have both Medicare Part A and Part B. The best time to buy a Medigap plan is during the Medigap Open Enrollment Period, which begins the month a person turns 65 and is enrolled in Part B.

Premiums vary by provider and location, and plans are renewable regardless of health status. Medigap provides peace of mind with predictable costs and broader coverage.

Medicare Part D Prescription Drug Plans

Medicare Part D is a federal program that helps Medicare beneficiaries pay for prescription drugs. It is offered through private insurance companies approved by Medicare. Part D coverage is available in two ways: as a standalone Prescription Drug Plan (PDP) that works with Original Medicare or as part of a Medicare Advantage Plan (Part C) that includes drug coverage. Plans vary in cost and coverage, but all must meet certain Medicare standards. Each plan has a formulary, or a list of covered drugs, which is divided into tiers affecting out-of-pocket costs. Beneficiaries typically pay a monthly premium, an annual deductible (if applicable), and copayments or coinsurance for medications.

Recent Changes for Part D Plans

A unique feature of Part D is the coverage gap, or “donut hole,” which temporarily increases costs after reaching a certain spending threshold. However, recent changes in the law have significantly reduced the financial burden during this phase by effectively removing the coverage gap. After beneficiaries spend enough to enter catastrophic coverage, their costs decrease substantially.

Enrollment in Part D is voluntary but may incur a penalty if delayed without other creditable drug coverage. The program is designed to make medications more affordable and accessible, enhancing healthcare outcomes for millions of Americans. Because premiums, copays, deductibles, coinsurance, and formularies do change, beneficiaries should compare plans annually to ensure optimal coverage. We can review your prescriptions and find the best plan for you.